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RSV COVID and flu

RSV, COVID and flu tips for a ‘3-bug’ winter | Ask the Pediatrician

Here's a rundown on RSV, COVID and flu and tips for keeping your family healthy.

Fall in the Pacific Northwest is stunning. crisp air, kids back in school and still some glorious weather. It is also the time of year to prepare for winter viral season. Sigh … we know it is coming, but we have lots of tools in our toolbox to keep our families safe.

This year, we’ll be coping with the flu, still coping with COVID-19, and are expecting another serious RSV (respiratory syncytial virus) season. The good news is, we have both the tried-and-true methods and some new approaches for helping keep your family healthy and safe. The top news here is a new vaccine that can protect infants from RSV, a potentially severe respiratory infection.

Here’s a rundown on RSV, COVID and flu:

RSV: what parents should know

RSV is common but can cause serious illness: Respiratory syncytial virus (RSV) is a respiratory virus that causes coldlike symptoms including runny or stuffy nose, sneezing, coughing, moderate wheezing, decreased appetite, and sore throat. It’s common, in fact almost all children have had an RSV infection by the time they are 2 years old, and many older kids and adults get it too.

Symptoms usually go away on their own in one or two weeks, but RSV infections can cause severe illness, hospitalizing about 58,000 to 80,000 children younger than 5 years old in the U.S. every year. Last year, because there had been so little RSV during the pandemic, kids lacked natural protection. We had a severe RSV season with more children sick and hospitalized and even a shortage of emergency room beds.

New RSV vaccine available: In August, the Centers for Disease Control and Prevention (CDC) recommended that babies up to 8 months old who are entering their first RSV season or are born during the season (typically fall through spring) should get the new injectable RSV drug. Some older infants between 8 and 19 months who are at increased risk of severe RSV disease and entering their second RSV season are also eligible.

In a study of nearly 1,500 infants, this medicine, Nirsevimab (also called Beyfortus), lowered the risk of a respiratory illness caused by RSV that required a doctor’s visit by nearly 75% for at least five months. Side effects were mostly mild including a rash or redness at the injection site.

The CDC is also looking at an RSV vaccine to be administered during pregnancy that will provide protection for newborns up through 6 months. Note for the older adults too: You can protect yourselves and your grandbabies with a new RSV vaccine for adults 60 and older.

For those keeping count, Nirsevimab is not technically a vaccine. It’s a long-acting monoclonal antibody product. That mouthful means that instead of stimulating an immune response to develop antibodies, it is ‘passive immunization’ that delivers the antibodies directly.


COVID and flu: what to know

The “three bug” winter: The CDC has already seen upticks in RSV in the Southern U.S., and that usually indicates it’s headed this way. Flu and cold season shows up around now and COVID continues to infect many Americans including kids.

How do we stay safe and healthy? Wash your hands! I can’t say that one enough. Infectious diseases like these can be prevented with simple measures like washing hands (or using hand sanitizer if you can’t use water and soap), covering your cough or sneeze with an elbow, and keeping your child home when they feel sick.

It’s also the right time to protect your family with vaccines. The earlier in the season you get vaccinated, the more protection. Some vaccines can be given together, so talk with your pediatrician about the best timing for your family.

RSV, COVID and flu: vaccines

RSV: This injection is for newborns and infants up to eight months old and for some infants and babies at increased risk of severe respiratory illness.

COVID: The new bivalent booster has been approved by the FDA and will be available as soon as this month or early next. It is expected to protect against severe disease and death from currently circulating variants. Children 5 years and older are eligible to receive the updated vaccine as a single dose (although it should be given at least two months since the last dose of any COVID -19 vaccine). Children 6 months to 5 years may need multiple doses to be up to date.

Influenza: The flu shot is updated annually as the virus evolves every year and is your best defense against the flu. Anyone six months or older can get the influenza vaccine.


More from Dr. Block and Kaiser Permanente in Seattle’s Child:


About the Author

Susanna Block

Dr. Susanna Block, MD, MPH, is a pediatrician with Kaiser Permanente in Seattle and lives with her family in Queen Anne.